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tolt <br /> K F; t....,+ �< i e s i�- ti ` �` i N. t gi �.,`a,: A � ZMW 3 a.3 ,Z6-AgN� !a$ r k; : O <br /> iYaRa ..,�"NN`i T �, gt T ai.>>� ` , Y I ESR RID V•r t L .at�.4 1` r a.2.2..,, t a6S Y <br /> . .4 L � :;;,yk..f �4 S va ¢a\ as rz -`.. i �.s .n,3 F F.. �,svi U t `a t�. ... k "� .F' .s. <br /> �.a_..Z.... � .. .,.... .._e...�.-_a: .x. `ti.....,.a..» 'Y.a a....,.�..: �.........v<.3 ..� .�...,...a...., a..�L.t.... .:a .. �.x..:.va\_,,.�.1:.,g.aaL .�..n .`a- .a.Y__k.� ...,....... Y. n.... .., <br /> Code Exemptions: <br /> A property owner,renter or lessee may purchase a permit to do an electrical installation on his/her own or qualified leased property under the <br /> conditions as described in RCW 19.28.261. <br /> A nonprofit corporation with current tax exempt status or a nonprofit religious organization may purchase an electrical permit as described in RCW <br /> 19.28.091(7). <br /> I am applying for the property owner exemption under the following conditions: <br /> You must select the option that applies to your situation: <br /> I swear under penalty of perjury that: <br /> ® <br /> I am a registered general contractor who is installing a temporary electrical service owned by me on a project where I am the general <br /> contractor <br /> OR <br /> I swear under penalty of perjury that I am: <br /> ® The owner of real property;or <br /> ® <br /> The renter or lessee of real property.(You must provide a signed letter from the owner of the property granting permission for you as the <br /> tenant to perform electrical work on the property);or <br /> ® <br /> A nonprofit corporation that holds a current tax exempt status as provided under 26 U.S.C.Sec.501(c)(3)or a nonprofit religious <br /> organization,and the total value of the electrical work does not exceed thirty thousand dollars($30,000.00). <br /> AND <br /> You must select the option that applies to your situation: <br /> ❑ <br /> A single family residence THAT IS NOT intended for rent,sale,or lease AND I will be personally doing the electrical work AND I will occupy <br /> the residence for at least 24 months after completion of the electrical work; <br /> ri A NEW 2,3,or 4 unit residential property that IS intended for rent,sale,or lease AND myself and/or a regularly scheduled and paid <br /> • employee(s)will be doing the electrical work AND I will occupy one of the units for at least 24 months after completion of the electrical work. <br /> O An EXISTING 1,2,3,or 4 unit residential property that IS intended for rent,sale,or lease AND myself and/or a regularly scheduled and paid <br /> employee(s)will be doing the electrical work; <br /> 0 A farm AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work; <br /> ® An EXISTING place of business AND I,personally,and/or a regularly scheduled and paid employee(s)will be doing the electrical work; <br /> ® <br /> A NEW place of business that is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid employee(s) <br /> will be doing the electrical work;or <br /> Other property that is NOT intended for rent,sale,or lease AND I,personally,and/or a regularly scheduled and paid employee(s0 will be <br /> ® doing the electrical work. <br /> . I am a nonprofit corporation that holds a current tax ecempt status as provided under 26 U.S.C.Sec.501(c)(3)or a nonprofit religious <br /> organization and the total market value of the electrical work does not exceed thirty thousand dollars($30,000.00),and th electrical work'will <br /> • be performed by appropriately certified electricians or certified and supervised trainees who are volunteering and not being compensatecFfor <br /> electrical work per RCW 19.28.091(7). <br /> 0 I AGREE and wish to purchase an electrical permit under the conditions described above. <br /> Owner Name(Print) <br /> Owner Signature Date <br /> PERMIT# Page 3-Affidavit <br />